Is percentage theatre utilisation data an accurate predictor of cost-effectiveness and performance in urology?

Abstract

Objective: The current economic and political climate demands a focus on efficiency and productivity, whilst delivering quality, across all aspects of the National Health Service (NHS). Operative theatres act as a critical, yet costly resource. The Audit Commission employs the use of percentage theatre utilisation as a principal measure of NHS operating theatre service and efficiency performance. We analysed theatre utilisation data in a five-consultant, high turnover, urology department within a NHS University Teaching Hospital. Our aim was to examine the relationship between theatre utilisation data, cost effectiveness and income generated. Patients and methods: Data on the usage of a dedicated urology theatre was collected over 251 hours for a full calendar month. A total of 176 consecutive procedures were performed. Linear regression analysis was performed to assess the correlation between number of operating hours, cases per hour, utilisation percentages and income generated. Results: There was no correlation between percentage theatre utilisation and income (R2=0.0191, p=0.82). No relationship was identified between percentage theatre utilisation and total number of cases performed (R2=0.0001, p=0.99). Although there appeared to be a positive correlation between the number of cases performed and income generated, this was not statistically significant (R2=0.725, p=0.067). Furthermore, there was no association between the number of cases performed per hour and income generated (R2=0.3184, p=0.32). Conclusion: Our data identifies no correlation between percentage theatre utilisation, income generated and number of cases performed. Utilisation percentages are not a reliable performance indicator when used in isolation, and therefore should be used as part of a more global picture when assessing cost effectiveness and efficiency performance.

Estruturação de um Sistema de Medição de Desempenho em centros cirúrgicos para apoiar iniciativas de >i<Lean Healthcare>/i<

“…Estudos reportam que o setor é um dos departamentos mais importantes para a geração de receita em hospitais, ao mesmo tempo em que corresponde à uma grande parcela dos custos da organização CIMA et al, 2011;MODGIL et al, 2013;ZENG et al, 2014;BENDER et al, 2015;DELDAR et al, 2017;HASSANAIN et al, 2017;PEDRON et al, 2017).…”

“…O foco na melhoria dos processos de um centro cirúrgico vem ganhando maior notoriedade recentemente, pois a ineficiência de salas cirúrgicas pode ser considerada um problema mundial, e que se melhorado, poderia impactar na realização de mais cirurgias, mantendo a mesma capacidade disponível e estrutura de custos (FAIZ et al, 2008;VAN VEEN-BERKX et al, 2014;FARRELLY et al, 2017). Visando beneficiar a experiência de pacientes e demais stakeholders, o uso mais eficiente dos recursos no setor de saúde preza pela minimização de atrasos, esperas e cancelamentos (MODGIL et al, 2013;BENDER et al, 2015;FONG;LANGERMAN, 2016).…”